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Antibiotics and Kefir

You’ve probably been told by family, friends and possibly even a physician or two to eat yogurt to counteract some of the adverse effects of antibiotics. The justification is that probiotics in yogurt replenish many of the healthy bacteria that are wiped out by such medications. But there’s another fermented dairy product on the block that you might also want to consider. Kefir is a drinkable source of probiotics that generally contains a higher proportion and broader range of active cultures than yogurt. This reality forms a strong theoretical basis for considering kefir during and after any antibiotic regimen.

The December 2010 issue of the Journal of Medicinal Foods makes the case for using kefir alongside antibiotics. An antibiotic regimen known as “triple therapy” is commonly employed to eradicate H. pylori in infected patients. This harmful bacterium is associated with intestinal inflammation, stomach cancer and ulcers. A 14-day randomized, double-blind study examined the effects of combining kefir or a placebo (milk) with an antibiotic-based treatment (amoxicillin, clarithomycin and lansoprazole). The kefir and placebo were given at a dosage of 250 ml or about 8 ounces twice-daily. The participants returned for an examination after 45 days. Questionnaires and a urea breath test were used to assess side effects and treatment success. The patients receiving the kefir-enhanced therapy achieved significantly higher H. pylori eradication – 78.2% vs. 50% in the placebo group. What’s more, those given the probiotic beverage reported “less frequent and less severe” side effects. (1)

Another group of researchers from St. Luke’s Medical Center in Duluth, Minnesota successfully employed kefir in 8 patients with “recurrent episodes of Clostridium difficile-associated diarrhea”. Antibiotic therapy using oral metronidazole or vanomycin was combined with daily kefir consumption. The dosage of antibiotics was gradually reduced and ultimately withdrawn. According to the author of the paper, “All eight successfully resolved their infection and did not experience any further diarrhea after completion of treatment”. Clostridium difficile infection or CDI is a leading cause of hospital-acquired, intestinal disease. Its incidence is increasing and so too is the virulence. New strains of C. defficile are leading to “increasing morbidity and mortality” in vulnerable populations. This is all the more reason why safe and effective adjuncts such as kefir need to be considered and employed where indicated. (2,3,4)

Kefir was the subject of a highly publicized trial that appeared in the August 2009 edition of the Archives of Pediatrics & Adolescent Medicine. The Georgetown University lead study examined the effects of a popular children’s kefir product on antibiotic-associated diarrhea (AAD). The trial itself was well designed and a most welcome opportunity for kefir to shine. Unfortunately, the findings didn’t reveal statistically significant benefits to kefir with live cultures vs. kefir containing heat-killed microbes. Future interventions using other products may help elucidate whether this finding is specific to kefir used here. Until then, I can tell you that the product in question (Probugs) contains a considerable amount of added sugar. The only type of kefir I recommend and use is the traditional, no-sugar added variety. (5)

Before combining kefir or yogurt with antibiotics, please be aware of the potential for adverse interactions. Many people express worry that taking probiotics in close proximity to antibiotics will nullify the benefits of the probiotics. This is a reasonable concern. However, there’s an even more pressing matter at hand. Dairy products contain a protein known as casein which may negatively affect the activity of select antibiotics. That’s why it’s important to inquire with your pharmacist and/or physician prior to selecting a probiotic food. One can often avoid such problems by consuming dairy a few hours apart from antibiotics or even selecting non-dairy sources of probiotics such as coconut milk kefir. That is also a good strategy to help keep the antibiotics from negating the benefits of the probiotics. (6,7,8)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

interessting article. A few days ago i read, that green tea works also very powerful against H. pylori and green tea enhances the effectivity of some (not all) antibiotics. looking for the links, will let you know. So maybee matcha green tea can be mixed with kefir a green super weapon .

you where faster with the links thx. Some interessting thing come to my mind: we have an golden retriver dog in our family, and the veterinarian told us, that these dogs where very prone to have H.pylori and would infect people with it. In fact my brother-in-law suffers regularly from h. pylori despite medical therapy (antibiotics…) he’s free of it for a few weeks, then it always came back. should we give the dog some green tea with his food? i recommended him additional to his therapy to eat manuka honey and drink green tea. hope that isn’t bad at all

Wish you and your girl a funny sunny and very relaxing weekend. i’m going to buy a lot of veggis today, for a glowy tan, so bad weather here, no sun for almost a week know

I have chronic bladder infections. I am on a antibiotic at night indefinitely . After 9 in 2 years I am at the end of my rope. A friend suggested the kefir. I have been drinking the milk kefir for 5 days now. I am concerned that the kefir might over power the antibiotic, and it may not work any more for me. I hate the thought of using a antibiotic for years to come. Would the kefir help with the infection?
Thank you for your help
MD

It may help. It depends on which antibiotic you’re using and various other factors – the specific bacteria involved, possible antiobiotic-resistance, etc. Admittedly, there’s not a lot of scientific data on this subject. I’ve described all I could find in the column above.

If I were you, I’d consider consulting with an integrative or naturopathic physician who may be able to re-direct your treatment plan. There may be an effective and safe way to ween you off of the antibiotics. But it will likely require an individualized approach and monitoring.

Hi, JP.
I just discovered your blog because you joined me on Twitter. i am delighted about you and your work.
I don’t do wheat (your article about Italian pasta dishes – I substitute with Rice pasta) and
I don’t do dairy product….. I take goat yoghurt because here in America they don’t have sheeps’ yoghurt as in Europe.
Do you know whether or not KEFIR exists here in the US made of sheep or goat milk?
I would appreciate this very much.
Belated – Happy New Year to you and yours

Hi, there.
I just read Missy’s horror story. If I may, I would like to share my personal experience. When I was young, 100 years ago, I had chronic bladder infections as well. The doctors stuffed my with antibiotics for 2 years. Every time with stronger and stronger doses. Until I realized they were treating the symptoms and not the cause. The true cause is usually a psychological issue (the soul is trying to tell you something that you do not want to see) which manifested physically. As JP mentioned, a homeopath is much better than a conventional doctor. I went to one, bit my teeth for a week to stand the pain and itching and, was healed. Homeopaths have several very effective substances that restore the balance in the bladder. Good luck to you. You have my full sympathy.

Effects of a kefir supplement on symptoms, colonic transit, and bowel satisfaction score in patients with chronic constipation: A pilot study.

BACKGROUND/AIMS:

Although probiotics have been extensively studied in irritable bowel syndrome, data on the impact of probiotics on chronic constipation are scarce. We aimed to evaluate the effects of kefir, which is a probiotic fermented milk product, on the symptoms, colonic transit, and bowel satisfaction scores of patients with chronic constipation.

MATERIALS AND METHODS:

Twenty consecutive patients with functional constipation according to the Rome II criteria were divided into two groups based on their colon transit studies: 1. The normal transit (NT) group (n=10); and 2. The slow transit (ST) group (n=10). After a baseline period, 500 mL/day of a probiotic kefir beverage was administered to all patients for 4 weeks. Defecation parameters (stool frequency, stool consistency, degree of straining, laxative consumption) were recorded in diaries daily by the patients. Bowel satisfaction scores were assessed using a visual analog scale. The colon transit study was repeated in the ST group at the end of the study.

RESULTS:

At the end of the study, the patients showed an increased stool frequency (p<0.001), improved stool consistency (p=0.014), and decreased laxative consumption (p=0.031). The degree of straining during evacuation showed a tendency to improve after kefir administration; however, this was not statistically significant (p=0.18). A repeat transit study showed an acceleration of colonic transit in the ST group (p=0.013). Bowel satisfaction scores also improved (p<0.001).

CONCLUSION:

This pilot study shows that kefir has positive effects on the symptoms of constipation. Our results also suggest that kefir improves bowel satisfaction scores and accelerates colonic transit. Controlled trials are warranted to confirm these findings.

Milk products are good sources of calcium that may reduce bone resorption and help prevent bone loss as well as promote bone remodeling and increase bone formation. Kefir is a product made by kefir grains that degrade milk proteins into various peptides with health-promoting effects, including antithrombotic, antimicrobial and calcium-absorption enhancing bioactivities. In a controlled, parallel, double-blind intervention study over 6 months, we investigated the effects of kefir-fermented milk (1,600 mg) supplemented with calcium bicarbonate (CaCO3, 1,500 mg) and bone metabolism in 40 osteoporosis patients, and compared them with CaCO3 alone without kefir supplements. Bone turnover markers were measured in fasting blood samples collected before therapy and at 1, 3, and 6 months. Bone mineral density (BMD) values at the spine, total hip, and hip femoral neck were assessed by dual-energy x-ray absorptiometry (DXA) at baseline and at 6 months. Among patients treated with kefir-fermented milk, the relationships between baseline turnover and 6 months changes in DXA-determined BMD were significantly improved. The serum β C-terminal telopeptide of type I collagen (β-CTX) in those with T-scores > -1 patients significantly decreased after three months treatment. The formation marker serum osteocalcin (OC) turned from negative to positive after 6 months, representing the effect of kefir treatment. Serum parathyroid hormone (PTH) increased significantly after treatment with kefir, but decreased significantly in the control group. PTH may promote bone remodeling after treatment with kefir for 6 months. In this pilot study, we concluded that kefir-fermented milk therapy was associated with short-term changes in turnover and greater 6-month increases in hip BMD among osteoporotic patients.

Some research has found that taking kefir in conjunction with triple therapy improves response rates and reduces side effects. Probiotic yogurt may be useful as well. There is dosing information in the links below:

METHODS: One hundred and sixty H. pylori-infected patients were randomized into a triple-plus-yogurt group or a triple-only group, receiving 1 week of triple therapy with and without supplements of AB-Yogurt, respectively. In the triple-plus-yogurt group, AB-Yogurt was continued for 4 weeks after triple therapy. Eight weeks later, patients were assessed for the success of H. pylori eradication. The stool samples of 22 randomly selected patients, 11 from each group, were provided on enrolment, at the first week and at the fifth week for evaluation of the percentage of Bifidobacterium in anaerobes.

RESULTS: By intention-to-treat analysis, the triple-plus-yogurt group had a higher H. pylori eradication rate than the triple-only group (91% vs. 78%, P < 0.05). The per protocol H. pylori eradication rates were similar for both groups (93.5% vs. 89%, P = N.S.). Only patients supplemented with AB-Yogurt showed restoration of the percentage of Bifidobacterium in the anaerobes of stools at the fifth week to the level in the stools on enrolment.

CONCLUSIONS: Supplement with AB-Yogurt can improve the intention-to-treat eradication rates of H. pylori, and can restore the depletion of Bifidobacterium in stools after triple therapy.

Ability of Lactobacillus kefiri LKF01 (DSM32079) to colonize the intestinal environment and modify the gut microbiota composition of healthy individuals.

BACKGROUND: Probiotics have been observed to positively influence the host’s health, but to date few data about the ability of probiotics to modify the gut microbiota composition exist.

AIMS: To evaluate the ability of Lactobacillus kefiri LKF01 DSM32079 (LKEF) to colonize the intestinal environment of healthy subjects and modify the gut microbiota composition.

METHODS: Twenty Italian healthy volunteers were randomized in pre-prandial and post-prandial groups. Changes in the gut microbiota composition were detected by using a Next Generation Sequencing technology (Ion Torrent Personal Genome Machine).

RESULTS: L. kefiri was recovered in the feces of all volunteers after one month of probiotic administration, while it was detected only in three subjects belonging to the pre-prandial group and in two subjects belonging to the post-prandial group one month after the end of probiotic consumption. After one month of probiotic oral intake we observed a reduction of Bilophila, Butyricicomonas, Flavonifractor, Oscillibacter and Prevotella. Interestingly, after the end of probiotic administration Bacteroides, Barnesiella, Butyricicomonas, Clostridium, Haemophilus, Oscillibacter, Salmonella, Streptococcus, Subdoligranolum, and Veillonella were significantly reduced if compared to baseline samples.

CONCLUSION: L. kefiri LKF01 showed a strong ability to modulate the gut microbiota composition, leading to a significant reduction of several bacterial genera directly involved in the onset of pro-inflammatory response and gastrointestinal diseases.

Therapeutic effect of lyophilized, Kefir-fermented milk on constipation among persons with mental and physical disabilities.

AIM: Constipation is a serious problem for persons with mental and physical disabilities in Japan. However, prophylaxis is extremely difficult because the major causes of constipation in these individuals are related to their mental and physical disabilities. Constipation can be successfully treated with glycerol enemas (GEs) and other aperients. As constipation is a lifetime issue for these persons, dietary regimens to prevent constipation can be important.

METHODS: This study evaluated the probiotic effects of kefir-fermented milk for preventing constipation in 42 persons with mental and physical disabilities. The participants were administered 2 g of lyophilized kefir with each meal for 12 weeks and their bowel movements, the administration of GE and other aperients, and stool shape were recorded.